Table 1. Summary of diagnostic evaluations.

MRSA: Methicillin-Resistant Staphylococcus aureus; CSF: Cerebrospinal Fluid; PCR: Polymerase Chain Reaction; HSV: Herpes Simplex Virus; AFB: Acid-Fast Bacilli; MTB: Mycobacterium tuberculosis complex

Infectious	Bacterial  MRSA nasal screen: negative CSF aerobic and anaerobic cultures: negative  Blood aerobic and anaerobic cultures: negative Mediastinal tissue culture: negative    Viral  CSF meningoencephalitis PCR negative (includes Escherichia coli K1, Haemophilus influenza, Listeria monocytogenes, Neisseria meningitidis, Streptococcus agalactiae, Streptococcus pneumoniae, cytomegalovirus, cytomegalovirus, enterovirus, herpes simplex virus 1 and 2, human herpesvirus 6, human parachovirus, varicella zoster, Cryptococcus neoformans) CSF HSV 1 and 2 PCR: negative CSF enterovirus PCR: negative CSF West Nile Virus PCR: negative Serum West Nile IgG/IgM: negative HIV 4th generation antigen/antibody: negative  Respiratory pathogen PCR panel: rhinovirus/enterovirus positive (includes adenovirus, coronavirus 229E, HKU1, NL63, OC43, human metapneumovirus, influenza A, A H1, A H1-2009, A H3, Influenza B, parainfluenza 1-4, respiratory syncytial virus A and B, Chlamydia pneumoniae, Mycoplasma pneumoniae)  Fungal  CSF Cryptococcus Ag: negative CSF Coccidioides Ab: negative Serum Coccidioides Ab: negative CSF fungal culture: no growth  Mediastinal tissue culture: no growth    Mycobacterial  CSF AFB stain & culture: no growth, AFB smear-negative CSF MTB PCR (8/22/19): negative Quantiferon gold: positive  Mediastinal tissue culture: positive for mycobacterium tuberculosis complex Next generation sequencing (NGS) plasma test: low positive for MTB complex PPD: positive at 10mm
Imaging	CT chest and abdomen w/ contrast: extensive pulmonary consolidation with necrotizing pneumonia and diffuse lymphadenopathy MRI brain with and without contrast MRI entire spine with and without contrast MR angiogram and MR venogram brain: normal
Pathology	CSF cytology: no malignant cells Mediastinal mass biopsy: necrotizing granulomas, AFB-positive and MTB complex PCR-positive
Genetic and metabolic	Whole genome sequencing (single): normal  CSF amino acids: moderately elevated glycine
Electroencephalogram	Diffuse slowing; no epileptiform discharges
Audiology	Brain auditory evoked response: mild peripheral abnormality on the left consistent with middle ear function